| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
55,296 |
46,999 |
$2.73M |
| T4526 |
Adult size pull-on med |
45,854 |
39,383 |
$2.11M |
| A4554 |
Disposable underpads |
65,311 |
58,933 |
$1.78M |
| T4528 |
Adult size pull-on xl |
34,618 |
29,586 |
$1.73M |
| A4335 |
Incontinence supply |
86,759 |
70,459 |
$1.60M |
| T4535 |
Disposable liner/shield/pad |
46,528 |
39,459 |
$1.59M |
| A4927 |
Non-sterile gloves |
110,906 |
90,180 |
$1.39M |
| T4541 |
Large disposable underpad |
43,543 |
32,615 |
$1.20M |
| B4150 |
Ef complet w/intact nutrient |
15,063 |
12,249 |
$1.09M |
| E1399 |
Durable medical equipment mi |
3,510 |
2,442 |
$981K |
| T4524 |
Adult size brief/diaper xl |
17,262 |
14,584 |
$977K |
| B4161 |
Ef ped hydrolyzed/amino acid |
2,052 |
1,276 |
$900K |
| E1390 |
Oxygen concentrator |
8,396 |
7,337 |
$843K |
| T4523 |
Adult size brief/diaper lg |
14,879 |
12,431 |
$786K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
3,904 |
3,774 |
$566K |
| B4035 |
Enteral feed supp pump per d |
3,200 |
2,708 |
$515K |
| T4544 |
Adlt disp und/pull on abv xl |
5,125 |
3,818 |
$455K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,717 |
3,247 |
$440K |
| B4154 |
Ef spec metabolic noninherit |
4,165 |
3,521 |
$435K |
| T4522 |
Adult size brief/diaper med |
8,315 |
6,860 |
$401K |
| A4245 |
Alcohol wipes per box |
45,827 |
39,737 |
$390K |
| A6250 |
Skin seal protect moisturizr |
38,875 |
34,503 |
$327K |
| T4525 |
Adult size pull-on sm |
6,870 |
5,576 |
$323K |
| T4543 |
Adult disp brief/diap abv xl |
2,754 |
2,027 |
$300K |
| E0431 |
Portable gaseous 02 |
7,549 |
6,584 |
$257K |
| B4149 |
Ef blenderized foods |
545 |
493 |
$241K |
| B4153 |
Ef hydrolyzed/amino acids |
332 |
307 |
$234K |
| B9002 |
Enter nutr inf pump any type |
4,024 |
3,632 |
$234K |
| E0445 |
Oximeter non-invasive |
3,125 |
2,957 |
$226K |
| T4540 |
Reusable underpad chair size |
9,664 |
6,894 |
$221K |
| A4624 |
Tracheal suction tube |
1,620 |
1,316 |
$218K |
| E0465 |
Home vent invasive interface |
381 |
337 |
$211K |
| S5199 |
Personal care item nos each |
15,800 |
14,043 |
$205K |
| E0466 |
Home vent non-invasive inter |
296 |
260 |
$169K |
| K0001 |
Standard wheelchair |
7,361 |
6,651 |
$166K |
| E0601 |
Cont airway pressure device |
3,070 |
2,731 |
$155K |
| E0255 |
Hospital bed var ht w/ mattr |
2,590 |
2,198 |
$154K |
| T4534 |
Youth size pull-on |
1,414 |
1,344 |
$146K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,556 |
1,342 |
$141K |
| A4353 |
Intermittent urinary cath |
324 |
253 |
$140K |
| B4034 |
Enter feed supkit syr by day |
1,880 |
1,723 |
$132K |
| B9998 |
Enteral supp not otherwise c |
3,028 |
1,866 |
$131K |
| A5120 |
Skin barrier, wipe or swab |
11,591 |
8,176 |
$117K |
| E0562 |
Humidifier heated used w pap |
4,083 |
3,868 |
$100K |
| E0471 |
Rad w/backup non inv intrfc |
389 |
361 |
$97K |
| E0277 |
Powered pres-redu air mattrs |
654 |
424 |
$95K |
| K0195 |
Elevating whlchair leg rests |
3,846 |
3,583 |
$93K |
| E0260 |
Hosp bed semi-electr w/ matt |
910 |
736 |
$76K |
| E0143 |
Walker folding wheeled w/o s |
1,237 |
1,195 |
$72K |
| E0630 |
Patient lift hydraulic |
1,402 |
1,255 |
$68K |
| A6402 |
Sterile gauze <= 16 sq in |
3,389 |
2,790 |
$65K |
| T4521 |
Adult size brief/diaper sm |
1,140 |
848 |
$62K |
| E0570 |
Nebulizer with compression |
917 |
871 |
$61K |
| E1060 |
Wheelchair detachable arms |
1,000 |
895 |
$59K |
| A4629 |
Tracheostomy care kit |
884 |
798 |
$57K |
| E1235 |
Rigid ped wc adjustable |
433 |
395 |
$54K |
| B4155 |
Ef incomplete/modular |
413 |
350 |
$52K |
| B4100 |
Food thickener oral |
1,079 |
813 |
$46K |
| T4530 |
Ped size brief/diaper lg |
578 |
566 |
$45K |
| E0600 |
Suction pump portab hom modl |
2,036 |
1,817 |
$44K |
| E0443 |
Portable 02 contents, gas |
1,954 |
1,019 |
$44K |
| E0619 |
Apnea monitor w recorder |
361 |
287 |
$43K |
| A4357 |
Bedside drainage bag |
1,930 |
1,461 |
$40K |
| E0470 |
Rad w/o backup non-inv intfc |
384 |
356 |
$36K |
| E0163 |
Commode chair with fixed arm |
560 |
545 |
$31K |
| K0006 |
Heavy duty wheelchair |
491 |
428 |
$30K |
| A6197 |
Alginate drsg >16 <=48 sq in |
67 |
65 |
$29K |
| A9900 |
Supply/accessory/service |
1,620 |
899 |
$29K |
| A7003 |
Nebulizer administration set |
1,780 |
1,619 |
$28K |
| E0550 |
Humidif extens supple w ippb |
491 |
410 |
$27K |
| A4349 |
Disposable male external cat |
906 |
656 |
$26K |
| A4450 |
Non-waterproof tape |
1,012 |
853 |
$24K |
| A6212 |
Foam drg <=16 sq in w/border |
106 |
96 |
$24K |
| A7048 |
Vacuum drain bottle/tube kit |
23 |
12 |
$23K |
| A7526 |
Tracheostomy tube collar |
1,256 |
949 |
$22K |
| A7508 |
Housing & integrated adhesiv |
369 |
329 |
$21K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
360 |
290 |
$20K |
| A4351 |
Straight tip urine catheter |
157 |
141 |
$19K |
| A7002 |
Tubing used w suction pump |
1,597 |
1,353 |
$19K |
| E0565 |
Compressor air power source |
875 |
833 |
$19K |
| A4623 |
Tracheostomy inner cannula |
227 |
205 |
$18K |
| K0007 |
Extra heavy duty wheelchair |
182 |
165 |
$17K |
| K0003 |
Lightweight wheelchair |
413 |
361 |
$16K |
| A4322 |
Irrigation syringe |
518 |
438 |
$16K |
| A4213 |
20+ cc syringe only |
362 |
295 |
$15K |
| E0240 |
Bath/shower chair |
281 |
160 |
$14K |
| E1392 |
Portable oxygen concentrator |
870 |
726 |
$13K |
| E0776 |
Iv pole |
1,231 |
1,124 |
$13K |
| A4409 |
Ost skn barr convex <=4 sq i |
162 |
128 |
$13K |
| A4425 |
Ost pch drain for barrier fl |
233 |
196 |
$12K |
| A4452 |
Waterproof tape |
302 |
271 |
$11K |
| A7520 |
Trach/laryn tube non-cuffed |
270 |
240 |
$10K |
| A5063 |
Drain ostomy pouch w/flange |
272 |
206 |
$9K |
| A6216 |
Non-sterile gauze<=16 sq in |
487 |
468 |
$8K |
| E0603 |
Electric breast pump |
218 |
82 |
$8K |
| T4532 |
Ped size pull-on lg |
67 |
65 |
$8K |
| A4338 |
Indwelling catheter latex |
255 |
223 |
$6K |
| A4358 |
Urinary leg or abdomen bag |
631 |
386 |
$6K |
| A4456 |
Adhesive remover, wipes |
315 |
283 |
$6K |
| A5061 |
Pouch drainable w barrier at |
105 |
87 |
$5K |
| A7000 |
Disposable canister for pump |
491 |
431 |
$5K |
| A7010 |
Disposable corrugated tubing |
286 |
270 |
$5K |
| T4529 |
Ped size brief/diaper sm/med |
63 |
57 |
$4K |
| E0156 |
Walker seat attachment |
258 |
252 |
$4K |
| E0245 |
Tub stool or bench |
132 |
130 |
$4K |
| A9270 |
Non-covered item or service |
633 |
541 |
$4K |
| A4406 |
Pectin based ostomy paste |
308 |
262 |
$4K |
| A4618 |
Breathing circuits |
207 |
191 |
$3K |
| A6446 |
Conform band s w>=3" <5"/yd |
270 |
260 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
29 |
27 |
$2K |
| A4385 |
Ost skn barrier sld ext wear |
54 |
42 |
$1K |
| A7525 |
Tracheostomy mask |
367 |
344 |
$1K |
| A4371 |
Skin barrier powder per oz |
281 |
245 |
$1K |
| A4311 |
Catheter w/o bag 2-way latex |
71 |
65 |
$959.21 |
| A4332 |
Lube sterile packet |
42 |
40 |
$936.16 |
| A7013 |
Disposable compressor filter |
416 |
359 |
$865.08 |
| A7015 |
Aerosol mask used w nebulize |
1,036 |
978 |
$862.04 |
| A4670 |
Automatic bp monitor, dial |
33 |
12 |
$656.44 |
| A7012 |
Nebulizer water collec devic |
161 |
151 |
$489.10 |
| K0739 |
Repair/svc dme non-oxygen eq |
27 |
26 |
$450.41 |
| A4253 |
Blood glucose/reagent strips |
13 |
12 |
$444.38 |
| A7007 |
Lg vol nebulizer disposable |
77 |
64 |
$282.28 |
| E0978 |
W/c acc,saf belt pelv strap |
16 |
15 |
$203.11 |
| A4402 |
Lubricant per ounce |
13 |
12 |
$70.93 |
| A4616 |
Tubing (oxygen) per foot |
50 |
46 |
$66.40 |
| A4244 |
Alcohol or peroxide per pint |
14 |
14 |
$55.41 |